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A Systematic Review of Interactive Computer-assisted Technology in Diabetes Care

Interactive Information Technology in Diabetes Care

  1. Chandra L. Jackson BS1,
  2. Shari Bolen MD, MPH2,
  3. Frederick L. Brancati MD, MHS1,2,
  4. Marian L. Batts-Turner MSN, RN, CDE2,
  5. Tiffany L. Gary PhD1

Article first published online: 22 DEC 2005

DOI: 10.1111/j.1525-1497.2005.00310.x

Issue

Journal of General Internal Medicine

Journal of General Internal Medicine

Volume 21, Issue 2, pages 105–110, February 2006

Additional Information

How to Cite

Jackson, C. L., Bolen, S., Brancati, F. L., Batts-Turner, M. L. and Gary, T. L. (2006), A Systematic Review of Interactive Computer-assisted Technology in Diabetes Care. Journal of General Internal Medicine, 21: 105–110. doi: 10.1111/j.1525-1497.2005.00310.x

Author Information

  1. 1

    Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

  2. 2

    Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

*Address correspondence and requests for reprint to Dr. Gary: 614 North Wolfe Street, Rm E6531, Baltimore, MD 21205 (e-mail: tgary@jhsph.edu).

  1. The authors have no conflicts of interest to report.

  2. The results were presented in part at the 64th Scientific Sessions of the American Diabetes Association, Orlando, FL, June 2004.

Publication History

  1. Issue published online: 8 MAR 2006
  2. Article first published online: 22 DEC 2005
  3. Manuscript received January 16, 2005 Initial editorial decision September 9, 2005 Final acceptance September 19, 2005

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Keywords:

  • type 2 diabetes;
  • information technology;
  • computer;
  • internet;
  • self-management;
  • clinical management;
  • interactive;
  • systematic review

BACKGROUND: Excellent diabetes care and self-management depends heavily on the flow of timely, accurate information to patients and providers. Recent developments in information technology (IT) may, therefore, hold great promise.

OBJECTIVE: To determine, in a systematic review, how emerging interactive IT has been used to enhance care for adults with type 2 diabetes.

METHOD: Eligible studies were randomized controlled trials (RCTs) and observational studies (both before-after designs and post-intervention assessments) focused on computer-assisted interactive IT that included ≥10 adults with diabetes (≥50% type 2) and reported in English. We searched 4 electronic databases (up to 2003) using terms for diabetes and technology, reviewed bibliographies, and handsearched Diabetes Care (January 1990 to February 2004). Two reviewers independently selected articles and worked serially on data extraction with adjudication of discrepancies by consensus.

RESULTS: There were 26 studies (27 reports): internet (n=6; 3 RCTs), telephone (n=7; 4 RCTs), and computer-assisted integration of clinical information (n=13, 7 RCTs). The median (range) sample size was 165 (28 to 6,469 participants) for patients and 37 (15 to 67) for providers; the median duration was 6 (1 to 29) months. Ethnic minorities or underserved populations were described in only 8 studies. Six of 14 interventions demonstrated moderate to large significant declines in hemoglobin A1c levels compared with controls. Most studies reported overall positive results and found that IT-based interventions improved health care utilization, behaviors, attitudes, knowledge, and skills.

CONCLUSIONS: There is growing evidence that emerging IT may improve diabetes care. Future research should characterize benefits in the long term (>1 year), establish methods to evaluate clinical outcomes, and determine the cost-effectiveness of using IT.

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